Provider Demographics
NPI:1437223393
Name:T&W CHIROPRACTIC SERVICES, INC.
Entity type:Organization
Organization Name:T&W CHIROPRACTIC SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHNATHAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:TINSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-864-9400
Mailing Address - Street 1:6958 NEXUS CT
Mailing Address - Street 2:STE 102
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-2648
Mailing Address - Country:US
Mailing Address - Phone:910-864-9400
Mailing Address - Fax:910-860-2417
Practice Address - Street 1:6958 NEXUS CT
Practice Address - Street 2:STE 102
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-2648
Practice Address - Country:US
Practice Address - Phone:910-864-9400
Practice Address - Fax:910-860-2417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2684111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890844JMedicaid
NC2454074OtherMEDICARE PROVIDER NUMBER
NC0844JOtherBCBS
NC7368199OtherAETNA
NCU86453Medicare UPIN